OSCE — Pseudofolliculitis barbae (razor bumps)

Brief (to candidate)

You will assess a patient with a presentation consistent with Pseudofolliculitis barbae (razor bumps).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Pseudofolliculitis barbae (PFB, razor bumps) is a chronic, recurrent inflammatory disorder of hair-bearing skin caused by ingrown hairs — a sharply cut, tightly curled hair shaft re-enters the skin after shaving and provokes a foreign-body granulomatous reaction. It overwhelmingly affects men of African descent with tightly curled facial hair (up to 60-80% of Black men who shave) and is a particular problem in the military and other clean-shaven occupations; it also affects women in the pubic, axillary and leg areas. Distribution: beard, especially the anterior neck, mandibular angle, chin and submental area. The word 'pseudo' is deliberate: this is NOT a primary folliculitis but a foreign-b

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).
8. Give immediate resuscitation steps.
9. Outline definitive management with doses/routes where standard.
10. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
11. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.^[1]